All information and comments are confidential, however, the Relative Respite Program and the Caregiver Resource Center are both partially funded through the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD).  Therefore, regardless of the age of the care recipient, we are required to share information provided in this application with DSAAPD.

Please note: 

*If you are assisting the caregiver with this application, please provide THEIR information, not yours.
*Caregiver refers to the person providing the majority of the care.
*Care recipient refers to the child for whom you are providing care.
*If you are providing care for more than one child, you may list them all on one application.
*If you feel you need additional support in filling out this application, or if you have questions, you may call our office at 302-221-2087 or 302-221-2076.

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